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C. Popescu, Violeta Bojincă, Daniela Opriş and Ruxandra Ionescu

alternative perspective . Am J ClinNutr 1996; 63 : 448S-451S. 27. ARMSTRONG T, BULL F. Development of the World Health Organization Global Physical Activity Questionnaire (GPAQ) . Journal of Public Health 2006; 14 : 66-70. 28. BULL FC, MASLIN TS, ARMSTRONG T. Global physical activity questionnaire (GPAQ): nine country reliability and validity study. J Phys Act Health 2009; 6: 790-804. 29. WESTHOVENS R, NIJS J, TAELMAN V, DEQUEKER J. Body composition in rheumatoid arthritis. Br J Rheumatol 1997; 36 : 444-448. 30. AKAR S, SARI I, COMLEKCI A

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Mariana Mihăilă, V. Herlea, Camelia Dobrea, Ioana Lupescu, Gina Rusu Munteanu, Grethi Chiriac, L. Micu, R. Serescu and I. Copaci


We present the case of a 76 year old female patient admitted in the Department of Cardiology for physical asthenia, profuse sweating and dyspnea with orthopnea for about one month. Clinical and paraclinical assessments performed at admission confirmed the diagnosis of cardiac tamponade. Surgical intervention was performed and 400 mL of clear effusion were drained. Post-operative evolution was marked by recurrence of symptoms, requiring after 3 weeks a new drainage of 600 mL of clear effusion, and biopsy of the pericardium was performed. Pathological exam described serous pericarditis with chronic inflammatory infiltrate, xanthogranulomatous reaction intricated in the pericardium and mesothelial hyperplasia. The patient was subsequently transferred to the Department of Internal Medicine for further investigations. Physical examination showed a patient with altered general status, pallor, vesicular murmur absent in both bases, presenting cutaneous hyperpigmentation at the level of the right hemi-abdomen and hip with posterior extension, and a peripheral indurated erythematous plaque. The patient presented nodular masses of 3 cm in the right latero-cervical and bilateral axillary regions, non-adherent to the superficial structures, as well as adenopathic blocks in both inguinal regions. CT scan of the thorax and abdomen showed moderate bilateral pleuresia, minimal pericardial effusion (15 mm) and multiple adenopathies on both sides of the diaphragm. Skin biopsy was performed, as well as bone marrow aspirate and excision of a right axillary lymph node. Pathological exams and immunohistochemistry tests confirmed the diagnosis of Plasma Cells Castleman disease.

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Seyed Reza Hosseini, Naghi Baghitabar, Ali Mirzapour, Farshid Oliaei, Hajighorban Nooreddini, Ali Bijani and Simin Mouodi

with fracture occurrence . Clin J Am Soc Nephrol. 2010; 5 (2):275-80. 13. AFSHINNIA F., SUNDARAM B., ACKERMANN RJ., WONG KK. Hyponatremia and osteoporosis: reappraisal of a novel association . Osteoporos Int. 2015; 26 (9):2291-8. 14. HOSSEINI SR., CUMMING RG., KHEIRKHAH F., NOOREDDINI H., BAIANI M., MIKANIKI E., et al . Cohort profile: the Amirkola Health and Ageing Project (AHAP) . International Journal of Epidemiology. 2014; 43:1393–1400. 15. PICKENBROCK HM., DIEL A., ZAPF A. A comparison between the Static Balance Test and the Berg Balance

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Philip H. Li and Chak Sing Lau

specific food and physical exertion (or other co-factors). Although first described more than 35 years ago, the exact pathogenesis of FDEIA or co-factor induced anaphylaxis has not been defined. It has been proposed that co-factors (such as exercise) may increase gut permeability leading to increased uptake of food allergens, lower the threshold allergen dose or augment IgE-mediated responses by direct mast cell/basophil degranulation. 4 Which single in vitro test would be most useful to confirm the diagnosis? Specific IgE to the wheat component omega-5-gliadin

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Ionel Copaci, Ioana Lupescu, Elena Caceaune, Grethi Chiriac and G. Ismail

:50-55. 14. BIDDINGER SB, HERNANDEZ-ONO A, RASK-MADSEN C, HAAS JT, ALEMAN JO, SUZUKI R, SCAPA EF, AGARWAL C, CAREY MC, STEPHANOPOULOS G, COHEN DE, KING GL, GINSBERG HN, KAHN CR. Hepatic insulin resistance is sufficient to produce dyslipidemia and susceptibility to atherosclerosis. Cell Metab 2008; 7:125-134. 15. IRWIN ML, AINSWORTH BE, MAYER-DAVIS EJ, ADDY CL, PATE RR, DURSTINE JL. Physical activity and the metabolic syndrome in a tri-ethnic sample of women. Obes Res 2002; 10:1030. 16. KATZMARZYK PT, CHURCH TS, BLAIR SN. Cardiorespiratory

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Chun-Pong Tang, Ka-Lai Lee and King-Yee Ying

limitations of physical activity Ordinary physical activity does not cause undue fatigue or dyspnoea, chest pain or heart syncope II Slight limitation of physical activity They are comfortable at rest. Ordinary physical activity results in undue fatigue or dyspnoea, chest pain or heart syncope III Marked limitation of physical activity They are comfortable at rest. Less than ordinary physical activity causes undue fatigue or dyspnoea, chest pain or heart syncope IV Inability to carry on any physical activity without symptoms. These patients manifest

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Chiu Sum Chu, Chi Hung To and Chi Chiu Mok

malaise. Systemic enquiry was unremarkable. Physical examination was non-revealing. Blood tests showed normocytic normochromic anemia of 9.7 g/L (NR: 11.6–15.5 g/L) with raised CRP (9.8 mg/L; NR < 5 mg/L) and ESR (75 mm/h; NR 5–34 mm/h). Otherwise, her liver and renal function tests, platelet and leucocyte counts were normal; her autoimmune serologies including anti-nuclear antibody, anti-extractable nuclear antibody, rheumatoid factor, antineutrophil cytoplasmic antibody (ANCA) were all negative. She was then referred to our clinic for further work-up. Upon our first

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Alexandra Ng Hoi Yan and Ng Kam Hung

peripheral arthritis are also not uncommon. Detailed physical examination during each visit is crucial for the overview assessment for patients with SpA. 2.1 Spinal Mobility For spinal mobility, ASAS has recommended to assess chest expansion, modified Schober’s test, occiput-to-wall distance, cervical rotation, and lateral spinal flexion. The Bath Ankylosing Spondylitis Metrology Index (BASMI) is an alternative instrument that includes the modified Schober’s test, cervical rotation, tragus-to-wall distance, lateral spinal flexion, and intermalleolar distance. In the

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Joyce Kit-Yu Young and Daniel Kam Hung Ng

, subsequent bone marrow aspiration found an active bone marrow. He was also found to have low titers of both antinuclear antibody (ANA) and anti-double-stranded deoxyribonucleic acid (anti-dsDNA) antibody. He was tested negative for the lupus anticoagulants (LA) and anti-cardiolipin (anti-CL) antibody. He was commenced on hydroxychloroquine and tapering doses of oral steroid. Two years later, the disease became quiescent and he had been drug free since. In 2001, he was hospitalized for exertional breathlessness and retrosternal chest discomfort. Physical examination was

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Tin Lok Lai

under treatment for nail onychomycosis, were excluded. 2.4 Demographics and Related Parameters Demographic data and disease related parameters, which included age, sex, body mass index, family history, age of onset and disease duration of skin psoriasis and PsA, were recorded. Based on the patients’ history, physical and radiographical findings, PsA was categorized into five subclasses: (1) oligoarthritis (<5 joints involvement), (2) polyarthritis (>= 5 joints involvement), (3) predominant distal interphalangeal joints involvement, (4) predominant axial